P A R T C D e c i s i o n u n d e r A p p e a l T h e d e c i s i o n u n d e r a p p e a l i s t h e M i n i s t ry o f S o c i a l D " m i n i s t r y " ) r e c o n s i d e r a t i o n d e c i s i o n o f N o v e m b e r 7 , t h r e e o f f i v e s t a t u t o r y r e q u i r e m e n t s o f s e c t i o n 2 o f t h D i s a b i li t i e s A c t ( " E A P W D A " ) f o r d e s i g n a t i o n a s a p e t h a t t h e a p p e l l a n t m e t t h e a g e r e q u i r e m e n t a n d t h a t a p p e l l a n t ' s i m p a i r m e n t i s l i k e l y t o c o n t i n u e f o r a t l e a s a t i s f i e d t h a t : • t h e e v i d e n c e e s t a b l i s h e s t h a t t h e a p p e l l a n t h a • t h e a p p e l l a n t ' s d a i l y l i v i n g a c t i v i t i e s ( " D L A " ) a d i r e c t l y a n d s i g n i f i c a n t l y r e s t r i c t e d e i t h e r c o n t h a t • a s a r e s u l t o f t h o s e r e s t r i c t i o n s , t h e a p p e l l a n t a n o t h e r p e r s o n , a n a s s i s t i v e d e v i c e , o r t h e s P A R T D R e l e v a n t L e g i s l a t i o n . E A P W D A , s e c t i o n 2 E m p l o y m e n t a n d A s s i s t a n c e f o r P e r s o n s w i t h D i s a b EAA T 0 0 3 ( 1 0 / 0 6 / 0 1 )A P P E A L # I --'-- -----� I e v e l o p m e n t a n d S o c i a l I n n o v a t i o n ( t h e 2 0 1 4 , w h i c h f o u n d t h a t t h e a p p � l l a n t d i d n o t m e e t e E m p l o y m e n t a n d A s s i s t a n c e f o r P e r s o n s W i t h r s o n w i t h d i s a b i l i t i e s ( " P W D " ) . � h e m i n i s t r y f o u n d i n t h e o p i n i o n o f a m e d i c a l p r a c t i t i o n e r t h e s t t w o y e a r s . H o w e v e r , t h e m i n i s t r y w a s n o t s a s e v e r e p h y s i c a l o r m e n t a l i r n p a i r m e n t ; r e , i n t h e o p i n i o n o f a p r e s c r i b e d p r o f e s s i o n a l , t i n u o u s l y o r p e r i o d i c a l l y f o r e x t e n d e d p e r i o d s ; a n d r e q u i r e s t h e s i g n i f i c a n t h e l p o r J u p e r v i s i o n o f e r v i c e s o f a n a s s i s t a n c e a n i m a l . 1 I i l i t i e s R e g u l a t i o n ( " E A P W D R " ) , s e c t i o n 2
P A R T E S u m m a o f F a c t s T h e a p p e l l a n t d i d n o t a t t e n d t h e a p p e a l h e a r i n g . H a t h e p a n e l p r o c e e d e d w i t h t h e h e a r i n g i n a c c o r d a n c e A s s i s t a n c e R e g u l a t i o n . T h e i n f o r m a t i o n b e f o r e t h e m i n i s t r y a t t h e t i m e o f r e c • T h e a p p e l l a n t ' s P W D a p p l i c a t i o n f o r m c o n s i s 2 0 1 4 ; a p h y s i c i a n ' s r e p o r t ( " P R " ) c o m p l e t e d b " p h y s i c i a n " ) o n J u l y 1 7 , 2 0 1 4 ; a n d a n a s s e s s o s e c o n d g e n e r a l p r a c t i t i o n e r ( " s e c o n d G P " ) o n • T h e a p p e l l a n t ' s R e q u e s t f o r R e c o n s i d e r a t i o n r e c o n s i d e r a t i o n s u b m i s s i o n d a t e d O c t o b e r 2 7 • A c o n s u l t a t i o n r e p o r t f r o m a c o n s u l t i n g s p e c i a D i a g n o s e s • I n t h e P R t h e a p p e l l a n t ' s p h y s i c i a n ( w h o h a s 1 2 m o n t h s ) d i a g n o s e d h i m w i t h d e g e n e r a t i v e p r o l a p s e L S . P h y s i c a l I m p a i r m e n t • I n t h e P R t h e p h y s i c i a n i n d i c a t e d t h a t t h e a p p f o r s u r g e r y . " H e a l s o c o m m e n t e d t h a t t h e a p p p a i n , t h a t h e e x p e r i e n c e s n u m b n e s s i n h i s r i g m o v e m e n t w i t h p a i n . • I n d e s c r i b i n g t h e a p p e l l a n t ' s f u n c t i o n a l s k i l l s , w a l k 4 + b l o c k s u n a i d e d o n a f l a t s u r f a c e , c a n a n d c a n r e m a i n s e a t e d f o r l e s s t h a n o n e h o u r • T h e s e c o n d G P ( w h o h a s k n o w n t h e a p p e l l a n i n t h e p a s t y e a r ) i n d i c a t e d i n t h e A R t h a t t h e a o f m o b i l i t y a n d p h y s i c a l a b i l i t y i n c l u d i n g s t a n d t y p i c a l w a l k i n g i n d o o r s a n d o u t d o o r s , a n d c l i m r e q u i r e s p e r i o d i c a s s i s t a n c e w i t h c a r r y i n g / h o l d c o m m e n t e d " u n a b l e t o [ i l l e g i b l e ] " . S h e a l s o c [ r i g h t ] l e g + d e g e n e r a t i v e d i s c d i s e a s e i n l o w e I n h i s c o n s u l t a t i o n r e p o rt o f A u g u s t 2 2 , 2 0 1 1 t h e c o n • A C T s c a n o f t h e l u m b a r s p i n e s h o w e d d i s c b s i g n i f i c a n t n e r v e r o o t c o m p r o m i s e a n d n o s p i n • T h e c h r o n i c b a c k p a i n i s l i k e l y s e c o n d a r y t o d • T h e a p p e l l a n t d o e s n o t h a v e a n y n e u r o l o g i c a l p r o l a p s e t h a t c o u l d c o n c e i v a b l y i r r i t a t e t h e L S s u r g e r y a t t h i s t i m e . • C o n s i d e r a t i o n s h o u l d b e g i v e n t o t h e u s e o f e e x a c e r b a t i o n o f b a c k a i n , b u t h e w o u l d d o m EAA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # v i n g c o n f i r m e d t h a t t h e a p p e l l a n t w a s n o t i f i e d , w i t h s e c t i o n 8 6 ( b ) o f t h e E m p l o y m e n t a n d o n s i d e r a t i o n i n c l u d e d t h e f o l l o w i n g : t i n g o f t h e a p p e l l a n t ' s s e l f r e p o r t � d a t e d A u g u s t 1 8 , y t h e a p p e l l a n t ' s g e n e r a l p r a c t i t o n e r ( t h e r ' s r e p o r t ( " A R " ) c o m p l e t e d b y t e a p p e l l a n t ' s S e p t e m b e r 8 , 2 0 1 4 . I f o r m w i t h a t t a c h e d t w o p a g e h a l d w r i t t e n , 2 0 1 4 . l i s t d a t e d A u g u s t 2 2 , 2 0 1 1 . I s e e n t h e a p p e l l a n t 1 1 o r m o r e t i m e s i n t h e p a s t d i s c d i s e a s e , f a c e t j o i n t o s t e o a h r i t i s , a n d d i s c e l l a n t ' s i m p a i r m e n t i s a " c h r o n i c j c o n d i t i o n n o t e l l a n t h a s r e c u r r e n t e p i s o d e s o s e v e r e b a c k h t l e g , a n d t h a t h e h a s a l i m i t e d l a n g e o f t h e p h y s i c i a n i n d i c a t e d t h a t t h e p p e l l a n t c a n c l i m b 5 + s t a i r s u n a i d e d , c a n l i f t 1 5 t o 3 5 p o u n d s , . t f o r t w o y e a r s a n d h a s s e e n h i m j t w o t o t e n t i m e s p p e l l a n t i n d e p e n d e n t l y m a n a g e i m o s t a s p e c t s i n g , b u t t h a t i t t a k e s h i m s i g n i f i c a n t l y l o n g e r t h a n b i n g s t a i r s . S h e a l s o i n d i c a t e d t h a t t h e a p p e l l a n t i n g . W i t h r e s p e c t t o l i f t i n g , t h e J e c o n d p h y s i c i a n o m m e n t e d " l o w e r b a c k p a i n + s c l 1 a t i c n e r v e p a i n r s p i n e / l u m b a r . " s u l t i n g s p e c i a l i s t r e p o r t e d t h a t : i u l g e s a t L 4 -5 a n d L 5 S 1 , w i t h n o e v i d e n c e o f a n y a l s t e n o s i s . i s c d e g e n e r a t i o n a n d f a c e t j o i n t s t e o a r t h r i t i s . d e f i c i t , a n d a l t h o u g h t h e r e i s a s m a l l d i s c n e r v e r o o t , h e w o u l d n o t r e c o m f e n d a n y p i d u r a l s t e r o i d s i f t h e a p p e l l a n t g e t s a n o r e f o r h i s c o n d i t i o n i f h e w e r e t o e t i n s h a e
a n d l o s e s o m e w e i g h t . I n h i s s e l f r e p o r t t h e a p p e l l a n t w r o t e t h a t : • H i s s c i a t i c a i s e x t r e m e l y p a i n f u l a n d c a n p e r s i s p i n c h e d . • T h e c o n s u l t i n g s p e c i a l i s t r e c o m m e n d e d n o s • A t i t s w o r s t a n d m o s t p a i n f u l t h e a p p e l l a n t h a d o w n , m a k i n g t a s k s a n d c h o r e s f o r h i m s e l f a • N u m b n e s s i s d u e t o n e r v e d a m a g e a n d c o n t r • H i s c o n d i t i o n h a s d i s r u p t e d b o t h p a s t a n d c u r a n d w a g e s . • H e i s c u r r e n t l y o n a w a i t i n g l i s t t o s e e t h e c o n a n d h e w a s r e c e n t l y d i a g n o s e d w i t h a b l o o d M e n t a l I m p a i r m e n t • I n t h e P R t h e p h y s i c i a n r e p o r t e d t h a t t h e a p p i n d i c a t e d t h a t t h e a p p e l l a n t h a s a s i g n i f i c a n t d t h e a r e a o f e m o t i o n , c o m m e n t i n g " D o m e s t i c p • I n t h e A R t h e s e c o n d G P c o n f i r m e d t h a t t h e a r e s p e c t s . • I n t e r m s o f c o g n i t i v e a n d e m o t i o n a l f u n c t i o n i n t w o o f f o u r t e e n c a t e g o r i e s : b o d i l y f u n c t i o n s a t h e a r e a s o f e m o t i o n a n d a t t e n t i o n / c o n c e n t r a c a t e g o r i e s . D LA • I n t h e P R t h e p h y s i c i a n i n d i c a t e d t h a t t h e a p p t r e a t m e n t s t h a t i n t e r f e r e w i t h h i s a b i l i t y t o p e r • T h e p h y s i c i a n r e p o r t e d t h a t t h e a p p e l l a n t i s u p r e p a r a t i o n , m a n a g e m e n t o f m e d i c a t i o n s , d a f u n c t i o n i n g . H e a l s o r e p o r t e d t h a t t h e a p p e l l a D L A m o b i l i t y i n d o o r s a n d o u t d o o r s . • T h e p h y s i c i a n i n d i c a t e d t h a t t h e a p p e l l a n t r e q s e l f c a r e , b a s i c h o u s e w o r k , u s e o f t r a n s p o r t a a n d o u t d o o r s . H e e x p l a i n e d h i s u s e o f t h e t e e x a c e r b a t i o n s o f p a i n . " • T h e s e c o n d G P r e p o r t e d t h e a p p e l l a n t i n d e p e p e r s o n a l s e l f c a r e ( t h o u g h r e q u i r i n g p e r i o d i c p r e p a r a t i o n , m a n a g e p e r s o n a l fi n a n c e s , m a n • T h e s e c o n d G P r e p o r t e d t h a t t h e a p p e l l a n t r e s h o p p i n g , a n d t h a t h e r e q u i r e s c o n t i n u o u s a s u s e o f t r a n s p o rt a t i o n ( u s i n g a n a s s i s t i v e d e v i c I n h i s r e c o n s i d e r a t i o n s u b m i s s i o n t h e a p p e l l a n t w r o t • T o p e rf o r m f u n c t i o n a l s k i l l s h e h a s t o f i g h t t h r i n a c t i o n . EAA T 0 0 3 ( 1 0 / 0 6 / 0 1 )I A P P E A L # i s t f o r u p t o t h r e e w e e k s a t a t i 7 e w h e n t h e n e r v e u r g e r y u n t i l t h e n e r v e d a m a g e g e t s w o r s e . s t r o u b l e w a l k i n g , s i t t i n g , s t a n d i � g a n d l a y i n g n d h i s c h i l d r e n d i f f i c u l t a n d t i m e f o n s u m i n g . i b u t e s t o l o s s o f b o w e l a n d b l a d tl e r c o n t r o l . r e n t e m p l o y m e n t , c a u s i n g a r e d � c t i o n i n h o u r s s u l t i n g s p e c i a l i s t a b o u t a n i s s u I 1 w i t h h i s f o r e a r m , c l o t t i n g i s s u e c a l l e d V o n W i l l e b r a n d d i s e a s e . I e l l a n t h a s n o d i ffi c u l t i e s w i t h c o n l i m u n i c a t i o n . H e e f i c i t i n c o g n i t i v e a n d e m o t i o n a l f u n c t i o n i n g i n r o b l e m s c u s t o d y b a t t l e . " p p e l l a n t ' s a b i l i t y t o c o m m u n i c a t e i s g o o d i n a l l I g , t h e s e c o n d G P r e p o r t e d m o d e r a t e i m p a c t s i n n d m o t i v a t i o n . S h e r e p o r t e d m i 1 1 i m a l i m p a c t s i n t i o n , a n d n o i m p a c t s i n t h e r e m a n i n g t e n e l l a n t h a s n o t b e e n p r e s c r i b e d a n y m e d i c a t i o n o r f o r m D L A . I n r e s t r i c t e d i n h i s p e r f o r m a n c e o � t h e D L A o f m e a l i l y s h o p p i n g , m a n a g e m e n t o f f i n a n c e s , a n d s o c i a l n t i s u n r e s t r i c t e d w i t h t h e i n d o o ,!s p o rt i o n o f t h e u i r e s p e r i o d i c a s s i s t a n c e w i t h t h e D L A p e r s o n a l t i o n , a n d t h e o u t s i d e a s p e c t s o f q i o b i l i t y i n d o o r s r m " p e r i o d i c " a s m e a n i n g " i n t e r m i t t e n t , s e v e r e n d e n t l y m a n a g e s a l l a s p e c t s o f t h e D L A o f a s s i s t a n c e f r o m a n o t h e r p e r s o n ) J m e a l a g e p e r s o n a l m e d i c a t i o n s , a n d s b c i a l f u n c t i o n i n g . q u i r e s p e r i o d i c a s s i s t a n c e w i t h t � e D L A d a i l y s i s t a n c e w i t h t h e D L A b a s i c h o u s e k e e p i n g a n d e f o r g e t t i n g i n a n d o u t o f a v e h i c l e . ) e t h a t : o u g h t h e p a i n o r f a c e t h e c o n s e q I u e n c e s o f l
• Tasks such a s eat ing, sho weri ng, getti ng d re ssed and d oin g d ishes take tw ice as lon g as typi cal. • Sh ower ing a nd d ressing can tak e up to an ho foo d s. • He has to k e ep wor k ing as he needs re nt to a at w o rk because hi s co ndi t i o n impai rs his p e rfo • He w a lks for an hour to g et to w o rk to save taxi which woul d take a norm al p er s on a ha l f hour. • The bes t p ain kil ler hi s p hysician ha s pr es crib h e ' s got hi s chi ldren a nd a ffects h is p e r for ma • He avoi ds sitt ing as it ma k e s his ba ck lock up. p ai nfu l. • He has lost ab out 100 pound s sin c e seeing the c improv ed. • H i s back can g o out from tasks as sm a ll as p icking grocerie s. He lp • In the PR the phys ician r e ported th a t the appell h i s impa ir ment , an d t ha t he ge ts assistance w • In the A R the second GP r eport e d t h a t the app an assistance an im a l, and a ssi sta nce is pr ovided t N ei t her pa rty p r o vid ed a ny additio nal i n formation on app EAAT 003(10/06/01) A PPEAL # ! , going to doctor or work, l a undry, cooki ng, ur a nd a half, a nd h e m ostly eats micro wavea ble I void ev i c tion. He ha s be en s ub� ec t to d iscipline r man ce on th e job . far e (there ar e no b uses a t ni g I h t), a distanc e ed i s a heavy seda tive w h ich he can't use whe n nce at wo rk. His ba c k p ain m akes b owe l c J ntrol di ffi cu lt a nd [ o nsul ti ng sp e cialist, b ut his !Ja ck has n ot up a n it em of clothing or as big as buying ant does not require a ny pr osth e ses or a ids for ith DLA fro m fa mily an d friends. ella nt r outinely uses a cane, h :=i does not hav e o the ap pell an t by his fami ly l . e al. j
PART F -Reasons for Panel D ecisi on The issue on this appe al is wheth e r the minist r y ' s deci P WO was r easonably s up ported by the e vidence or enactment in the circumstances o f the a p pellan t . In p determ i n i n g that the appellan t doe s not have a severe phys opinion of a prescribed professional t he appellant' s im restri ct him from perfor m ing DLA eithe r conti nuously a resul t o f those restrictions the a p pellant does not require help t The rel evant legislation is as follows: EAPWD A: 2 (1) In this se cti on: "assi stiv e device" means a device de s igne a ctiv ity that, bec ause of a s eve r e me n tal or perfo r m; " d ail y li ving a cti v it y" h as the p rescribed m "prescribed prof ess i o nal" h as the (2) T he m inist e r ma y desi g nate a pers o n w disabil it ies for the pur p os es of this A c t if th mental or phy s ical i mpa i rment that (a) in the o pinion of a m edi cal years, an d (b) in the o pinion o f a p re sc ribed ( i ) di r ectly and signi ficant livi n g activities either (A) cont inuousl ( 8) pe r iodica lly (ii) as a result of those restrictions, the person require those activiti es. (3) For the purposes of subs ection (2), (a) a person who has a severe men mental disorde r, and (b) a person requi res help in relation perform it, the person requires (i) an assistive device, (ii) the s ignificant h elp o (iii) the services of an assistance animal. EAAT 003( 10/06 /0 1) APPEAL# ! s ion to deny th e app ellant d esignation as a I wa s a reason able application oti the applicable a rticular , was t h e min is t ry reasonable in ical or mental i mpairm e � t, and t h at in the p a irments do not directly a nd significa n tly or periodica l ly for extend ed periods, and that as o perform DLA. d to enable a person to perform a daily l iving p hy sic al impairm ent, the pers on is unable to ea n i ng ; prescribed m ean i ng. ho has reached 1 8 y ears o f age r s a pe rson w it h e mini s t er i s sa t is fied tha t the pe r son has a s eve re practitioner is likely to conti nue f or at leas t 2 profes sion a l l y re s tr i cts the pe rson's abi li � to perf orm daily y, or f o r ex t e n de d p e riods, an d s help to perform tal impairment include s a person with a to a daily living activity if, in ord er to r supervision of a not her person, o r
I APPEAL# EAPWDR section 2(1): 2 (1) For the purposes of the Act and this regulation, "daily living activities" , (a) in relation to a person who has a severe physical impairment or a severe mental impairment, means the following activities: (i) prepare own meals; (ii) manage personal finances; (iii) shop for personal needs; (iv) use public or personal transportation facilities; (v) perform housework to maintain the person's place of residence in acceptable sanitary condition; (vi) move about indoors and outdoors; (vii) perform personal hygiene and self care; (viii) manage personal medication, and (b) in relation to a person who has a severe mental impairment, includes the following activities: (i) make decisions about personal activities, care or finances; (ii) relate to, communicate or interact with others effectively. (2) For the purposes of the Act, "prescribed professional" means a person who is (a) authorized under an enactment to practise the profession of (i) medical practitioner, (ii) registered psychologist, (iii) registered nurse or registered psychiatric nurse, (iv) occupational therapist, (v) physical therapist, (vi) social worker, (vii) chiropractor, or (viii) nurse practitioner, or (b) acting in the course of the person's employment as a school psychologist by (i) an authority, as that term is defined in section 1 (1) of the Independent School Act, or (ii) a board or a francophone education authority, as those terms are defined in section 1 (1) of the School Act, if qualifications in psychology are a condition of such employment. ******* Severe Physical Impairment The appellant's position is that his back pain and associated difficulties such as numbness, when coupled with anxiety and depression, constitute a severe physical impairment. He argued in his reconsideration submission that his original application form had been misplaced, so when the medical practitioners filled them out for the second time they were in a hurry and weren't as detailed as the were the first time. He also ar ued that thou h he has taken ste s to lose wei ht and et in EAAT 003(10/06/01)
s h ape, his ba c k has n ot improv e d as it is a d e gen erative m i nim al e xerti on. The minist r y' s posit ion, as s e t out i n its r ec ons iderat demonstrating a severe physi c a l impair men t. The mi able to d o most aspec ts of mo b i l i ty a nd ph ys ical abi l argu ed the back pai n is per iodic with n o inf o rm ation Pan el D e cision A diag nosis of a serio us m edic al co ndit ion do es not in severe im pairmen t. A n "im pa ir m ent " i s a med ic al cond ab i l ity t o fu n c tion inde pend ently or e f fect ive ly. To as sess the se veri ty of an impa irmen t one m us t consid extent o f its impa c t on daily fu ncti onin g a s e v iden ce d wh ich performin g DL A is res tr i cte d . A med ical b arr ier emp loy m e nt is no t a l egis lat e d c rite rion for s eve rity . dete rmin ation of severity i s at the di scr eti on of th e minis Howev er, the leg islat ion i s al so cle ar t hat t he fun damental a presc rib ed p r ofess iona l -in th is ca se, the a p pell a nt's I n term s of phys ical functi ona l skill s, th e p hys ici an's mid-to hi gh end of the scale exc ept for the abilit y t o obser vation s of th e s econ d GP an d th e app e llant w h mana g es his mobi lity, thou gh it ta k es him lon ger t han ty in dic ated that he walks up to an ho ur to and fro m work. th e evi d e nce of th e physi cia n and th e s e cond GP with th e appella n t p rovided no evi d ence to cont r a d i ct t he p T h e pane l n ote s that se ctio n 2(2) of the EA PW D A require di ag n o sed by a med ical pr a ctit ion e r. There is no evidence the appellant's Von Willebrand disease or any restrictions it may impose on the appellant's funct ioni ng. As discussed in more det ail in the subsequent section of thi Restrictio ns to DL A , any l imi tations re sulting from the appellant's impairments do not appear t translated into significant restr ic tions i n hi s ability to manage his DLA independen F o r the foregoing reasons, th e panel has c o n cluded is a serious matter, the ministry reasonably determined that the evidence falls short of establishing that he has a severe physical impairment as contemplated by the legislation. Severe Mental Impairment The appellant advanced no argument with respect to a mental impairment. however, that he is experiencinq depression and anxiety which diminishes his motivation to work and EAAT 003(10/06/01) I APPEA L# cond ition which can go out at an y ti me w ith ion decis ion , is that the evi dence falls short of nist ry arg u ed that the appe l la nt i s in depen dentl y i ties with p eriodic h elp to ca rr y /ho ld . I t also on fr eque ncy or duration of s evere impairment. itself determin e PWD e lig ibilit y or e s ta b lis h a ition that resul t s i n restri c ti ons t o a p er son's er the n at u re of th e imp airment and the by f unc t ional skill limi tat ions a nd th e d egree to to t he appell a nt's abili ty t o en ga ge in paid T h e l egislati on makes it c le a r tha t the te r, taki n g i nto acc ount al l of the ev iden ce. basis fo r the an alysis i s t he e vid e nce fro m ph ysicia n and seco nd G P. obse rva tio ns put t he appell a nt's abi lit ies at the r ema in seat e d. This is consi sten t with the o i n di c at e d th a t t he app el lant in d e p e ndent ly p ical to w a l k outdoo r s . The a pp ellan t There appears to be some inc o n si sten cy in r es pe ct to th e app e llan t's li fting capa cit y, but h ysi cian on this poin t. s a severe p hys ical impai rm e nt to be fr o m a medica l p rac titio ner with respe ct to s decision under the heading Significant o have tl y. t hat w hile the pain ex perie nced by the appellant He did point out,
I APPEAL# perform DLA. The ministry's position is that the evidence does not establish a severe mental impairment. The ministry argued that the medical practitioners provided no diagnosis of a mental impairment, and that the second GP identified only moderate impacts to two of fourteen categories of cognitive and emotional functioning. Panel Decision The evidence from the health professionals provides no diagnosis of a mental impairment, though the physician and second GP each indicated that there are some impacts to cognitive and emotional function. The second GP described moderate impacts to two of fourteen aspects of cognitive and emotional functioning. Section 2(2) of the EAPWDA requires a severe impairment to be diagnosed by a medical practitioner. The lack of a diagnosis, along with the comments of the physician -linking the deficits in the appellant's emotional function to his domestic situation -tend to indicate that the appellant's depression and/or anxiety are situational rather than being the result of a mental disorder. Section 2(1)(b) of the EAPWDR prescribes two DLA that are specific to mental impairment-make decisions about personal activities, care or finances (decision making), and relate to, communicate or interact with others effectively (social functioning). The second GP's evidence indicates that the appellant is not significantly restricted with respect to decision making in that he independently manages the decision making aspects of meal preparation (meal planning), manage personal medication (filling/refilling/taking as directed), social functioning (making appropriate social decisions) and manage personal finances (budgeting). The second GP indicated that the appellant requires periodic assistance with making appropriate choices when shopping, but she has provided no explanation of why this is so and there is no evidence of what sort of assistance, if any, the appellant receives with this task. The evidence of the physician and the second GP when read together indicates that the appellant independently manages all aspects of social functioning. Considering that: • there is no diagnosis from a medical professional as to a mental impairment, • the appellant's ability to communicate is good in all respects, • the appellant is not significantly restricted in terms of decision making and social functioning, and • the evidence indicates limited impacts to cognitive and emotional functioning, the panel concludes that the ministry reasonably determined that it does not demonstrate a severe mental impairment. Significant Restrictions to DLA The appellant's position is that his back and leg pain, coupled with his depression and anxiety, significantly restrict his ability to perform his paid employment and his DLA. He argued that his back can " o out" at an time, and that the resultin ain can be exacerbated for u to three weeks after EAAT 003(10/06/01)
o n e o f t h e s e o c c u r r e n c e s . T h e m i n i s t r y ' s p o s i t i o n i s t h a t t h e e v i d e n c e i s n o t s u i m p a i r m e n t s i g n i f i c a n t l y r e s t r i c t s h i s a b i l i t y t o p e r f o r m e x t e n d e d p e r i o d s . T h e m i n i s t r y a r g u e d t h a t t h e e v i d a p p e l l a n t i n d e p e n d e n t l y m a n a g e s t h e m a j o r i t y o f h i s f r e q u e n c y o r d u r a t i o n o f t h e p e r i o d i c a s s i s t a n c e r e q u m i n i s t r y a l s o a r g u e d t h a t a s t h e p h y s i c i a n i n d i c a t e d p o u n d s , t h e p e r i o d i c a s s i s t a n c e h e r e q u i r e s f o r t h e s h e a v i e r w e i g h t s . P a n e l D e c i s i o n T h e l e g i s l a t i o n s . 2 ( 2 ) ( b ) ( i ) o f t h e E A P W D A r e q u a n d s i g n i f i c a n t r e s t r i c t i o n s o f D L A i n c o n s i d e r a t i o n o c a s e t h e a p p e l l a n t ' s p h y s i c i a n a n d s e c o n d G P . T h i f a c t o r e d i n a s r e q u i r e d t o p r o v i d e c l a r i f i c a t i o n o f t h e l a n g u a g e m a k e s i t c l e a r t h a t t h e p r e s c r i b e d p r o f e s s i d e t e r m i n a t i o n a s t o w h e t h e r i t i s " s a t i s f i e d " . T h e l e g i s l a t i o n r e q u i r e s t h a t a s e v e r e i m p a i r m e n t d i r a b i l i t y t o p e r f o r m D L A e i t h e r c o n t i n u o u s l y o r p e r i o d i c m e a n s t h a t t h e r e m u s t b e a c a u s a l l i n k b e t w e e n t h e r e s t r i c t i o n m u s t a l s o b e s i g n i f i c a n t . F i n a l l y , t h e r e i s a d i r e c t a n d s i g n i f i c a n t r e s t r i c t i o n m a y b e e i t h e r c o n t i n e x t e n d e d t i m e . I n h e r e n t l y , a n y a n a l y s i s o f p e r i o d i c i t f r e q u e n c y . A l l o t h e r t h i n g s b e i n g e q u a l , a r e s t r i c t i o n s i g n i f i c a n t t h a n o n e w h i c h o c c u r s s e v e r a l t i m e s a w e e v i d e n c e i n d i c a t e s t h a t a r e s t r i c t i o n a r i s e s p e r i o d i c a e v i d e n c e o f t h e d u r a t i o n a n d f r e q u e n c y o f t h e r e s t r i c c r i t e r i o n i s m e t . T h e p a n e l u n d e r s t a n d s t h e a p p e l l a n t ' s f r u s t r a t i o n w i t f r o m h i s p h y s i c i a n a n d s e c o n d G P w h i c h h e f e e l s d o r e s t r i c t i o n s . H o w e v e r , t h e p a n e l i s r e q u i r e d t o p l a c e I n t h i s c a s e , t h e e v i d e n c e o f t h e p h y s i c i a n a n d s e c o n i n d e p e n d e n t l y m a n a g e s a l l a s p e c t s o f f i v e o f t h e t e n o f m e d i c a t i o n s , m a n a g e m e n t o f f in a n c e s , d e c i s i o n m i n d e p e n d e n t l y m a n a g e s m o s t a s p e c t s o f m o b i l i t y i n d C o n s i d e r i n g t h e e v i d e n c e a s a w h o l e , i t i n d i c a t e s t h a s e v e r e p a i n w h e n h i s b a c k " g o e s o u t " . T h e a p p e l l a n t h e p a i n i s e x a c e r b a t e d f o r u p t o t h r e e w e e k s a f t e r s f r o m t h e m e d i c a l p r a c t i t i o n e r s o r t h e a p p e l l a n t a s t o e p i s o d e s o f e x a c e r b a t e d p a i n . T h e r e i s a l s o n o e v i d t h e a p p e l l a n t r e c e i v e s w i t h D L A . EAA T 0 0 3 ( 1 0 / 0 6 / 0 1 )A P P E A L # I f f i c i e n t t o d e m o n s t r a t e t h a t t h e a p p e l l a n t ' s D L A e i t h e r c o n t i n u o u s l y o r p e r i o d i c a l l y f o r e n c e o f t h e m e d i c a l p r a c t i t i o n e r s s h o w s t h a t t h e D L A , a n d t h a t t h e r e i s n o i n d i c a t i o n o f t h e i r e d b y t h e a p p e l l a n t w i t h o t h e r D L A . T h e t h e a p p e l l a n t c a n w a l k 4 + b l o c k s a n d l i f t 1 5 t o 3 5 e a c t i v i t i e s m u s t b e f o r l o n g e r d i s t a n c e s a n d i r e s t h e m i n i s t e r t o s u b s t a n t i a l l y a s s e s s d i r e c t f t h e o p i n i o n o f a p r e s c r i b e d p r o f e s s i o n a l , i n t h i s s d o e s n ' t m e a n t h a t o t h e r e v i d e n c e s h o u l d n ' t b e p r o f e s s i o n a l e v i d e n c e , b u t t h e l e g i s l a t i v e o n a l ' s o p i n i o n i s f u n d a m e n t a l t o t h e m i n i s t r y ' s e c t l y a n d s i g n i f i c a n t l y r e s t r i c t s t h e a p p e l l a n t ' s a l l y f o r e x t e n d e d p e r i o d s . T h e t e r m " d i r e c t l y " s e v e r e i m p a i r m e n t a n d t h e r e s t r i c t i o n . T h e d i r e c t c o m p o n e n t r e l a t e d t o t i m e o r d u r a t i o n . T h e u o u s o r p e r i o d i c . I f i t i s p e r i o d i c i t m u s t b e f o r a n y m u s t a l s o i n c l u d e c o n s i d e r a t i o n o f t h e t h a t o n l y a r i s e s o n c e a y e a r i s l e s s l i k e l y t o b e e k . A c c o r d i n g l y , i n c i r c u m s t a n c e s w h e r e t h e l l y , i t i s a p p r o p r i a t e f o r t h e m i n i s t r y t o r e q u i r e t i o n i n o r d e r t o b e " s a t i s f i e d " t h a t t h i s l e g i s l a t i v e h w h a t h e p e r c e i v e s t o b e i n a d e q u a t e e v i d e n c e e s n o t a c c u r a t e l y p o rt r a y t h e e x t e n t o f h i s s i g n i f i c a n t w e i g h t o n t h e p r o f e s s i o n a l e v i d e n c e . d G P i s c o n s i s t e n t t h a t t h e a p p e l l a n t p r e s c r i b e d D L A : m e a l p r e p a r a t i o n , m a n a g e m e n t a k i n g , a n d s o c i a l f u n c t i o n i n g . H e a l s o o o r s a n d o u t d o o r s . t t h e a p p e l l a n t i s s u b j e c t t o e p i s o d i c p e r i o d s o f t i n d i c a t e d t h a t i t c a n g o o u t a t a n y t i m e , a n d t h a t u c h a n i n c i d e n t . T h e r e i s , h o w e v e r , n o e v i d e n c e h o w o f t e n t h e a p p e l l a n t e x p e r i e n c e s t h e s e e n c e a s t o t h e t y p e o r f r e q u e n c y o f a s s i s t a n c e
APPEAL# I There are references in the evidence to the impact the appellant's medical conditions have on his ability to work at paid employment. The panel notes that employability is not a statutory criterion regarding PWD designation -the focus of the legislation is on the ability to perform DLA. In the panel's view, paid employment generally requires a higher level of functionality than DLA. Based on the foregoing analysis, the panel concludes that the ministry reasonably determined that the evidence is insufficient to show on the balance of probabilities that the appellant's ability to perform his DLA is significantly restricted either continuously or periodically for extended periods. Help with DLA The appellant advanced no argument with respect to requiring assistance with DLA. The ministry's position is that since it has not been established that the appellant's DLA are significantly restricted, it cannot be determined that significant help is required from other persons. The ministry argued that no assistive devices are required. Panel Decision A finding that a severe impairment directly and significantly restricts a person's ability to manage his DLA either continuously or periodically for an extended period is a precondition to a person requiring "help" as defined by section 2(3)(b) of the EAPWDA. For the reasons provided above, that precondition has not been satisfied on the balance of probabilities in this case. Accordingly, the panel finds that the ministry reasonably concluded it could not be determined that the appellant requires help with DLA as defined by section 2(3)(b) of the EAPWDA. Conclusion The panel acknowledges that the appellant's medical condition affects his ability to function. However, having reviewed and considered all of the evidence and the relevant legislation, the panel finds that the ministry's decision finding the appellant ineligible for PWD designation is a reasonable application of the legislation in the circumstances of the appellant. The panel therefore confirms the ministry's decision. EAAT 003(10/06/01)
You are being directed to the most recent version of the statute which may not be the version considered at the time of the judgment.